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From the 1/21/2022 release of VAERS data:

Found 1,049,249 cases where Vaccine is COVID19 and Patient Did Not Die

Government Disclaimer on use of this data



Case Details (Reverse Sorted by Onset Date)

This is page 157 out of 10,493

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VAERS ID: 2005502 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-10-28
Onset:2021-12-24
   Days after vaccination:57
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 076C21A / 2 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chest X-ray abnormal, Cough, Diarrhoea, Dyspnoea, Pleural effusion, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 12 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unkown
Preexisting Conditions: Rt AKA, Lt BKA
Allergies: unknown
Diagnostic Lab Data: 12/24/2021: Sars cov2-positive CHEST 1 VIEW (AP) 12/24/2021: There is a small hazy left basilar effusion. Left upper lung is clear.
CDC Split Type:

Write-up: 12/24/2021: Event occurred after 2nd vaccine. Patient is a 61-year-old male presents emerged from and secondary difficulty breathing for 2 to 3 days. Denies chest pain fever. He has had a mild cough. He states he has had diarrhea. Associated Symptoms: cough, Shortness of breath


VAERS ID: 2005547 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-25
Onset:2021-12-24
   Days after vaccination:274
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA NOT DOUMENTED / 1 AR / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA NOT DOCUMENTED / 2 AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury, Anal incontinence, Asthenia, Blood creatinine increased, Blood lactic acid, Blood sodium decreased, C-reactive protein increased, COVID-19, Chest X-ray abnormal, Clostridium difficile colitis, Condition aggravated, Cough, Diarrhoea, Electrolyte imbalance, Fatigue, Fibrin D dimer increased, Hypotension, Laboratory test abnormal, Lung disorder, Malaise, Myalgia, Panniculitis, Presyncope, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Pseudomembranous colitis (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Chronic kidney disease (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Tumour lysis syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 500 MG tablet albuterol HFA (PROVENTIL HFA, VENTOLIN HFA, PROAIR HFA) 108 (90 Base) MCG/ACT inhaler (Expired) CARBOXYMETHYLCELLUL-GLYCERIN OPTH Cinnamon 500 MG TABS dilTIAZem (CARDIZEM CD) 120 MG 24 hr capsule DULox
Current Illness:
Preexisting Conditions: OSA (obstructive sleep apnea) Exertional dyspnea Wheezing Viral URI with cough Peripheral arterial disease s/p bypass Atrial fibrillation Benign essential HTN RBBB Chronic systolic (congestive) heart failure Atherosclerosis of aorta hx of GI bleed hx of C. difficile colitis hx of colon adenoma polyps Morbid obesity Gastroesophageal reflux disease without esophagitis Arthritis of both knees Lumbar stenosis and radiculopathy Lower extremity neuropathy, left Type 2 diabetes mellitus with diabetic polyneuropathy, without long-term current use of insulin Degenerative disease of nervous system, unspecified Diabetic peripheral neuropathy associated with type 2 diabetes mellitus Renal cyst Microalbuminuria due to type 2 diabetes mellitus AKI (acute kidney injury) Dyslipidemia Diabetic skin ulcer associated with type 2 diabetes mellitus
Allergies: Tramadol
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized 12/24/2021; COVID-19 positive 12/24/2021; fully vaccinated Discharge Summary Date of Admission: 12/24/2021, Hospital Day: 8 Date of Discharge: 12/31/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Diarrhea Panniculitis Weakness Hypotension, unspecified hypotension type Diarrhea, unspecified type COVID-19 C. difficile colitis HOSPITAL COURSE: 77 yo/ man with PMH of A fib on Xarelto, type II DM, HTN and recurrent C diff who was recently admitted from 12/7-12/11 with second episode of c diff colitis and have completed a 14 days course of po VAnco on 12/21 with plan to continue a slow taper every 7 days. He tapered his oral vanco on schedule from qid to tid and very quickly developed worsening diarrhea to the point of incontinence and associated presyncopal episode. The last couple of days he has increasing fatigue, malaise, myalgias and dry cough. Due to worsening diarrhea and malaise and another presyncopal episode today, he called ambulance and came to the ED. Labs in the ED with sodium of 129, Cr of 1.32, LA of 1.9, covid PCR positive, CXR with Patchy bilateral airspace disease, predominating in the periphery of both lungs but NOT requiring Oxygen. Patient received monoclonal antibody for COVID on 12/25. His CRP 228 and Ddimer 1440 not a remdesivir nor decadron candidate on room air. Patient was already on NOAC. Upped his vanco po dose to qid with plans of very slow taper per his outpatient regime. His electrolytes and fluid imbalance and mild AKI addressed. C.difficile testing was negative, however. His diarrhea could be secondary to covid too. His oral vancomycin was held and diarrhea improved. He was discharged to SAR in stable and improved condition.


VAERS ID: 2005578 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-12-24
Onset:2021-12-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ8762 / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT RECEIVED AN EXPIRED DOSE OF THE PFIZER BOOSTER VACCINE.


VAERS ID: 2005588 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-12-24
Onset:2021-12-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ8762 / 3 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT RECEIVED AN EXPIRED DOSE OF THE PFIZER BOOSTER VACCINE.


VAERS ID: 2005600 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-12-24
Onset:2021-12-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ8762 / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT RECEIVED AN EXPIRED DOSE OF THE PFIZER BOOSTER VACCINE.


VAERS ID: 2005611 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-10-01
Onset:2021-12-24
   Days after vaccination:84
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / 3 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram abnormal, Constipation, Heart rate increased, Nephrectomy, Ovarian cyst, Palpitations, Pyrexia, Red blood cell count increased, Ultrasound pelvis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec 1 daily
Current Illness: Minor thyroid infection
Preexisting Conditions: N/A
Allergies: Sulfa, Latex.
Diagnostic Lab Data: CT Scan they found Ovarian cyst and evidence of constipation, Pelvic ultrasound
CDC Split Type: vsafe

Write-up: I went to the Hospital on 12/21/2021 I stayed 5 night because I had a kidney removed and on the 12/24/2021 is when I felt like my heart was pounding and raisin, My pulse was 152, I was having a low grade fever, elevated my red cell count.


VAERS ID: 2005693 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-12-17
Onset:2021-12-24
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 064H21A / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Gait disturbance, Oropharyngeal pain, Pain, Rash, Rhinorrhoea, Sensitive skin
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Tired and sore arm
Other Medications: NA
Current Illness: NA
Preexisting Conditions: Anemia
Allergies: Tomatoes Potatoes; Peppers
Diagnostic Lab Data: NA
CDC Split Type: vsafe

Write-up: Developed a rash, runny nose, productive, sore throat, full body rash prescribed Benadryl - 50mg as Prednisone pack as needed. Body pain all over, trouble walking, skin sensitive.


VAERS ID: 2005786 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-12-22
Onset:2021-12-24
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8030 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain lower, Computerised tomogram abnormal, Epiploic appendagitis, Peripheral swelling, Pruritus, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CT Scan
CDC Split Type:

Write-up: Legs swelled up with rash and itching. Pain in left lower abdomen. CT Scan showed Appendagitis.


VAERS ID: 2005945 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-12-15
Onset:2021-12-24
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Superficial vein thrombosis, Ultrasound scan abnormal
SMQs:, Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: telmisartan 40mg. hydrochlorothyazide 12.5 mg. Atorvastatin 10 mg.
Current Illness: none
Preexisting Conditions: controlled high blood pressure controlled hyperlipidemia
Allergies: none known
Diagnostic Lab Data: ultra sound test 12/28/2021
CDC Split Type:

Write-up: development of a Greater Saphenous Venous Thrombosis


VAERS ID: 2006269 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-12-21
Onset:2021-12-24
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032H21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Ocular hyperaemia, Pain, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Glaucoma (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertraline and unknow OTCS
Current Illness:
Preexisting Conditions:
Allergies: Cephalexin
Diagnostic Lab Data: Nothing
CDC Split Type:

Write-up: On the third day she had hives on her neck and red eyes and ears. In addition, she felt pretty achy as well.


VAERS ID: 2006516 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-12-22
Onset:2021-12-24
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 33130BA / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chest pain, Dysgeusia, Headache, Paraesthesia, Paraesthesia oral
SMQs:, Peripheral neuropathy (broad), Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Apirin 81mg,---Atacand HCT 16mg-12.5mg---Calicium---Carvedilol 3.125mg 2x---Lovastatin 40mg---Multivitamin---Vitamin B12---Vitamin C---Vitamin D3
Current Illness: No illnesses
Preexisting Conditions: High blood pressure and cholesterol
Allergies: No allergies
Diagnostic Lab Data: No medical tests done but I have been in contact with my HCP
CDC Split Type:

Write-up: I received my 1st Pfizer vaccine on 4/7/21 and my 2nd on 4/27/21. I had mild headache and slight aches for a couple of days and a slight metallic taste for about a week after each shot. I received my Pfizer Booster on 12/22/21. As of today 1/5/22 I still have the headache (fuzzy behind the eyes). I also had shooting pains starting in my left shoulder blades reaching to my left neck, these only lasted a couple of days and were sporadic. I have had some chest pain as well. For the last 2 weeks I have been experiencing tingling in my legs/ feet progressed to my arms and now have constant tingling in my lips. I''ve taken tylenol and naproxen.


VAERS ID: 2010483 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-01
Onset:2021-12-24
   Days after vaccination:267
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 2 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, COVID-19, Cardiac failure congestive, Chest X-ray normal, Condition aggravated, Cough, Diarrhoea, Dyspnoea, Malaise, Positive airway pressure therapy, Pulmonary oedema, Rales, SARS-CoV-2 test positive
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: CHF, CAD, prosthetic mitral valve, pulm htn, HTN, BPH
Allergies: unknown
Diagnostic Lab Data: 12/29/2021: Tested externally COVID-positive. Not tested at Hospital CXR- Lungs show no interval development of pneumothorax, focal consolidation, or new pleural effusion. No change in the pulmonary vasculature .
CDC Split Type:

Write-up: 12/29/2021: Event occurred after 2nd vaccine. 77-year-old male who comes to the emergency department today for shortness of breath. Patient states that he has been Covid positive and has had symptoms for about 7 days now. He states his symptoms are shortness of breath, cough, weakness, diarrhea. Denies any syncope, vomiting, chest pain, abdominal pain. He does have some crackles in the bases and was given a dose of Bumex as CHF could be contributing to his shortness of breath with a combination of his Covid illness. On mid flow patient''s oxygenation would not get above 87%. Given this he will be placed on BiPAP as it will help improve his oxygenation and help get some of the fluid out of his lungs. Re 01/06/2022- remains in hospital. Outpatient positive for COVID-19 12/24. S/p remdesivir, Dexamethasone 6 mg daily for total 10 days


VAERS ID: 2010534 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-10-01
Onset:2021-12-24
   Days after vaccination:84
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Cough, Oropharyngeal pain, Pain, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec, Wellbutrin, Lexapro, vitamin D, multivitamin, evening primrose oil
Current Illness: none
Preexisting Conditions: asthma
Allergies: none
Diagnostic Lab Data: Postive rapid covid test at home on 12/25/2021 Positive PCR covid test 12/27/2021
CDC Split Type:

Write-up: Breakthrough Covid-19 infection. cough, runny nose, sore throat, fever, body aches


VAERS ID: 2010553 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-12-23
Onset:2021-12-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FL3194 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Cognitive disorder, Dizziness, Dysstasia, Fatigue, Feeling abnormal, Gait disturbance, Mental impairment, Myalgia, Vertigo
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Vestibular disorders (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Dose 1 & 2.
Other Medications: Cymbalta; Adderall XR; trazodone; spironolactone; norethindrone; magnesium citrate; vitamin D
Current Illness: No
Preexisting Conditions: Fibromyalgia
Allergies: No
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: It started on 12/24/2021, severe muscle and joint pain, along with severe fatigue and brain fog. Dizziness, vertigo and difficulty standing and walking. Pt stated that she (Dyscognition), haven''t been able to think straight.


VAERS ID: 2010813 (history)  
Form: Version 2.0  
Age: 6.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-12-07
Onset:2021-12-24
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FL0007 / 2 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Miralax.
Current Illness: None.
Preexisting Conditions: None.
Allergies: None.
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: About 10PM, she had a fever of 102 and I did not provide medication and checked it throughout the night and it self-resolved without intervention by 6AM. She did have diarrhea in her sleep, but that could be related to on going issues she already has. 12/25 she had another temp of 101 at 8PM and resolved in the morning without intervention.


VAERS ID: 2010877 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-11-01
Onset:2021-12-24
   Days after vaccination:53
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 071F21A / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Chest pain, Cough, Headache, Influenza like illness, Malaise, Nasal congestion, Pain, Pyrexia, SARS-CoV-2 test positive, Sinus disorder
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: High blood pressure and Diabetes Medications
Current Illness: None
Preexisting Conditions: High blood pressure and type 2 diabetes.
Allergies: None
Diagnostic Lab Data: Covid
CDC Split Type: vsafe

Write-up: Covid symptoms started on 12/24/2021 and felt like I had the flu. Symptoms were nasal congestion, coughing, body aches, and a slight fever. They lasted several days. I tested positive on 12/24/21. I started taking zpak 2 days ago. I also had chest pain, sinus issues, and a headache.


VAERS ID: 2011016 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: California  
Vaccinated:2021-12-14
Onset:2021-12-24
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 070H21A / 3 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Mechanical urticaria, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Acne
Allergies: None
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Dermatographia of the entire skin appeared 10 days after receiving the COVID-19 booster shot. It has persisted so far for at least 2 weeks. Hives appear on the skin when itched or rubbed, and remain for around 30 minutes before subsiding.


VAERS ID: 2013948 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-12-24
Onset:2021-12-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Insomnia, Lymphadenopathy
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Na
Preexisting Conditions: Na
Allergies: N/a
Diagnostic Lab Data: Na
CDC Split Type:

Write-up: Swollen lymph nodes of armpit of I njectiin site, severe insomnia since day of vaccination (booster), swollen lymph nodes resolved in around 10 days. Insomnia still persists. No anxiety issues.


VAERS ID: 2014118 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-25
Onset:2021-12-24
   Days after vaccination:213
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: fever, cough + COVID test


VAERS ID: 2014124 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-10-12
Onset:2021-12-24
   Days after vaccination:73
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Myalgia, Respiratory tract congestion, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: congestion, cough, myalgias + COVID test


VAERS ID: 2014196 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: California  
Vaccinated:2021-12-21
Onset:2021-12-24
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C12A / 3 - / -

Administered by: Private       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Thrombosis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Swelling at the injection site after 2nd COVID-shot
Other Medications: I was taking prenatal vitamins , iron vitamin, and Vitamin C.
Current Illness: None.
Preexisting Conditions: None.
Allergies: None.
Diagnostic Lab Data: None.
CDC Split Type: vsafe

Write-up: Couple of days after the vaccine I started bleeding heavy, and I had a massive blood clot which is what made me go to the hospital. I was monitored at the hospital me and the baby. Estimate date of delivery - Feb 19, 2021


VAERS ID: 2014230 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-12-13
Onset:2021-12-24
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 067H21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Magnesium, D3
Current Illness: None
Preexisting Conditions: Migraine
Allergies: None
Diagnostic Lab Data: Non
CDC Split Type:

Write-up: Hives began to appear on my face and body. They still continue as of 1/7. I am taking methylprednisol, Zyrtec and Pepcid


VAERS ID: 2014243 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-10-01
Onset:2021-12-24
   Days after vaccination:84
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 3 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Colonoscopy, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: losartan hydrochlorothiazide, simvastatin, baclofen, metaxalone, krill oil od, glucosamine / chondroitin, Citracal, magnesium, Zyrtec, Pepcid AC, eye vitamin, lutein, zeaxanthin , vitamin C, zinc, 1 Aleve, Turmeric, Prolia injections for br
Current Illness: no
Preexisting Conditions: 4 spine surgeries, 2 cervical and 2 lumbar from 2003 to 2008
Allergies: INH to stave off TB, horse serum
Diagnostic Lab Data: not yet
CDC Split Type: vsafe

Write-up: 12/24/2021- I was sitting at the table have Christmas dinner, I moved my foot, I notice my left foot had gone to sleep. I tried to shake it to wake it up, but it stayed asleep. The next morning the whole left leg was also asleep. It is not numb, It is usable, it is just asleep. And it stayed asleep since 12/24/2021, the whole left leg, all the way up to the waist. We are thinking it is a pinched nerve. I have an appointment with the specialist at a Spine doctor next week. To let them figure it out. I called my doctor through email and she referred me to a Spine doctor. Note: I did have a colonoscopy on 11/01/2021.


VAERS ID: 2014294 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-04
Onset:2021-12-24
   Days after vaccination:50
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Guillain-Barre syndrome
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 15 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Guillen-Barre Syndrome


VAERS ID: 2014351 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-12-23
Onset:2021-12-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FL3197 / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Gait disturbance, Vaginal ulceration, Vulvovaginal pain
SMQs:, Severe cutaneous adverse reactions (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Abilify, Trazadone, Fludrocortisone
Current Illness: Dysautonomia
Preexisting Conditions: exercise induced asthma
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extremely painful vaginal ulcers.. Patient was taken to hospital. Needed to be admitted for pain control but no beds were available. Two weeks later, they are still there and very painful. Patient can''t walk.


VAERS ID: 2014443 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-11-29
Onset:2021-12-24
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 33030BD / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Arterial disorder, Blood fibrinogen normal, Blood immunoglobulin G increased, Blood lactate dehydrogenase increased, Computerised tomogram thorax abnormal, Fibrin D dimer, Gingival bleeding, Heparin-induced thrombocytopenia, Hypoxia, Influenza A virus test negative, Influenza B virus test, Influenza virus test negative, Mouth haemorrhage, Platelet count decreased, Platelet factor 4, Pulmonary embolism, Respiratory syncytial virus test negative, SARS-CoV-2 test negative, Ultrasound Doppler normal
SMQs:, Asthma/bronchospasm (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Gingival disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Divalproex - pre2012; Ipratropium Nasal spray; Levetiracetam (8/2021); prochloperazine; propranolol; sumatriptan nasal solution; triamcinolone topical cream; Pfizer Bion Tech given as a booster - Prior vaccinbes were Covid 19 Moderna Spike
Current Illness: NONE
Preexisting Conditions: Nonintractable epilepsy without status epilepticus; Achondroplasia; Hydrocephalus with VP shunt; Migraine
Allergies: NONE
Diagnostic Lab Data: Plt count 161 x10(9)/L 11/29/2021 day of vaccine ; Plt count 55 x10(9)/L 12/24 presentation to hospital- heparin started PLT 43 x10(9)/L 12/25 heparin stopped argatroban started 12/25/2021; PLT count 62 x10(9)/L 12/26/2021; PLT 88 x10(9)/L 12/27/2021; PLT Count 150x10(9)/L 12/28/2021 CTE PE 12/24/2021 shows " Filling defects in a subsegmental pulmonary artery of the anterior left lower lobe- IMPRESSION: 1. Subsegmental anterior left lower lobe pulmonary embolus. No other pulmonary emboli identified.2. No focal airspace consolidation. No pneumothorax." 4 extremity dopplers 12/25 show no evidence for DVT 12/24/2021 D-Dimer 1.22; 12/24/2021 COVID/Influenza A&B/RSV not detected for all ; 12/25/2021 Hep-Ind Thrombocytopenia PF4 Ab, IgG lab test is POSITIVE : Screen = 0.46 OD units (likely muted by some heparin contamination from the initial infusion. The presence of heparin may falsely lower the result ); Confirm = 0.13 OD units ; % inhibition 98%. If the patient was not exposed to heparin in the weeks prior to the ELISA test, this may represent a rare example of vaccine induced thrombotic thrombocytopenia. 12/25/2021 Lactate dehydrogenase blood 316 U/L 12/25/2021 Fibrinogen Quant 222 mg/dL
CDC Split Type:

Write-up: Presented to Hospital with acute hypoxia - Acute Pulmonary embolism, with Thrombocytopenia with no clear cause and no previous heparin 25 days post Covid Vaccine. Heparin was administered to treat PE with further drop in platlet count within 12 hours. VITT reaction considered (PLT 161 11/29 to 55 12/24 ) heparin stopped immediately switched to argatroban infusion with increase in platelets within 24 hours . Hep-Ind Thrombocytopenia PF4 Ab, IgG lab test sent for evaluation, returned positive see section 19 and continuation page for detail. Transitioned to rivaroxaban (Xarelto) once stable and discharged from the hospital. Mouth/gums were bleeding during the hospital admission PE is being treated - he continues to take anticoagulation medication and will get further follow up . Platelet count was recovered at time of discharge


VAERS ID: 2014454 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: California  
Vaccinated:2021-12-21
Onset:2021-12-24
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041J21A / 3 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: No known allergies/Drug allergies as noted in record.
Diagnostic Lab Data:
CDC Split Type:

Write-up: 72 hours, experienced Urticaria (Hives) on left posterior flank, bilateral forearm and legs. Legs symptoms has resolved as of now.


VAERS ID: 2014480 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-11-19
Onset:2021-12-24
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8020 / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Dyspnoea, Fatigue, Influenza like illness, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: Covid-19 test.
CDC Split Type: vsafe

Write-up: I had fever, fatigue, SOB, light cough, and difficulty breathing. I had a sore throat and flu like symptoms. These lasted for about 10 days. I did a at home Covid-19 test, positive results. I went to my doctor after that. She did a physical exam and just asked about my symptoms.


VAERS ID: 2014665 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: California  
Vaccinated:2021-12-23
Onset:2021-12-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 068H21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Burning sensation, Injection site erythema, Injection site swelling, Injection site warmth, Pain, Pruritus, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Moderna
Other Medications: None at the time recorded.
Current Illness: UTI
Preexisting Conditions: None
Allergies: No
Diagnostic Lab Data: None. The doctor didn''t even look at my arm.
CDC Split Type:

Write-up: On 12/24 Throat constriction and both arms itched and burned. On 12/28 Injection site swollen, hot to touch and very red. Had body aches that lasted through 12/31. Went to Urgent care on 12/30 but the doctor refused to give me a copy of the visit. He evidently didn''t want to deal with it. Vaers also has an adverse reaction I had to first shot on02/28/2021. E-Report Number: 334192.Date of report 03/04/2021. Needless to say, I won''t be getting any more shots.


VAERS ID: 2014944 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-12-23
Onset:2021-12-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Injection site erythema, Injection site inflammation, Injection site pain, Injection site swelling, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Next day following vaccine, site was sensitive to touch, red, and inflamed. The site would decrease in size when ibuprofen was taken and when effects of drug decreased, the site would grow in size again. Left arm was sore to raise and site felt tight when lifting arm. Inflammation, redness, and soreness continued for 4 days post vaccine.


VAERS ID: 2017442 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-12-24
Onset:2021-12-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1855191 / 2 LA / OT

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature, Chest pain, Chills, Heart rate, Oxygen therapy, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NAPROSYN
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Body temperature; Result Unstructured Data: 100.5; Test Name: Oxygen supplementation; Result Unstructured Data: 98 %; Test Name: Pulse rate; Result Unstructured Data: 90''s
CDC Split Type: USJNJFOC20211258418

Write-up: CHEST PAIN; CHILLS; FEVER; This spontaneous report received from a parent concerned an 18 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient was previously received non-company bnt 162 vaccine (dose number in series was 1) (form of admin, route of admin not reported, batch number: FW0161) dose was not reported, administered on 19-APR-2021 for prophylactic vaccination. On an unspecified date, the patient experienced chest pain following vaccination with non-company bnt 162 vaccine (dose number in series was 1). The patient previously received non-company bnt 162 vaccine (dose number in series was 1) (form of admin, route of admin not reported, batch number: ER8736) dose was not reported, administered on 19-MAY-2021 for prophylactic vaccination. On an unspecified date, the patient experienced chest pain following vaccination with non-company bnt 162 vaccine (dose number in series was 1). The patient received covid-19 vaccine ad26.cov2.s (dose number in series was 2) (suspension for injection, route of admin not reported, batch number: 1855191 expiry: 11-APR-2022) dose was not reported, 1 total, administered on 24-DEC-2021 to Left Deltoid for prophylactic vaccination. Concomitant medications included naproxen. On 24-DEC-2021, within 6 hours from vaccination, the patient experienced fever, chest pain and chills following vaccination with covid-19 vaccine ad26.cov2.s (dose number in series was 2). Laboratory data (dates unspecified) included: Body temperature (not provided) 100.5 (units unspecified), Oxygen supplementation (not provided) 98 %, and Pulse rate (not provided) 90''s. The patient received treatment with Aleve. Patient''s chest pain symptom was faded. Patient''s health care professional (HCP) suspected that the vaccination causes chest pain. Patient did not go to emergency room (ER) and was discussed with an ER doctor. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from chills on 25-DEC-2021, and fever, and was recovering from chest pain. This report was non-serious.


VAERS ID: 2017453 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-01
Onset:2021-12-24
   Days after vaccination:267
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / OT
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: SARS-CoV-2 test, Suspected COVID-19, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20211227; Test Name: COVID-19 virus test; Result Unstructured Data: Positive Covid-19
CDC Split Type: USJNJFOC20211260954

Write-up: SUSPECTED CLINICAL VACCINATION FAILURE; SUSPECTED COVID-19 INFECTION; This spontaneous report received from a patient concerned a female of unspecified age, race and ethnicity. Initial information was processed along with the additional information received on 29-DEC-2021. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (Janssen dose number in series 1) (suspension for injection, route of admin, and batch number were not reported) dose was not reported,1 total, administered on APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. The patient received additional non-company suspect vaccine included: BNT 162 (dose number in series 2) (form of admin, route of admin, and batch number were not reported) dose was not reported, administered on DEC-2021 for prophylactic vaccination. No concomitant medications were reported. On 24-DEC-2021, the patient experienced mild congestion. She stated the symptom was only upper respiratory (subsumed under suspected Covid-19 infection), no cough or fever. On 27-DEC-2021, the patient had done home kit test [not PCR (polymerase chain reaction) test] and was tested positive for Covid-19, hence had suspected clinical vaccination failure (Dose number in series 1 and 2). She was fully vaccinated. The action taken with covid-19 vaccine ad26.cov2.s, and BNT 162 was not applicable. The outcome of the suspected clinical vaccination failure and suspected covid-19 infection was not reported. This report was serious (Other Medically Important Condition). This report was associated with product quality complaint: 90000209408.; Sender''s Comments: V0: 20211260954-covid-19 vaccine ad26.cov2.s-Suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 2017584 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-30
Onset:2021-12-24
   Days after vaccination:269
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / OT

Administered by: Other       Purchased by: ?
Symptoms: Asymptomatic COVID-19, SARS-CoV-2 test
SMQs:, COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (Quarantined for 10 days.); Comments: The patient was quarantine for five days after the second time of corona. The patient had underlying health conditions.
Allergies:
Diagnostic Lab Data: Test Date: 20211224; Test Name: COVID-19 PCR test; Result Unstructured Data: Positive
CDC Split Type: USJNJFOC20220107561

Write-up: ASYMPTOMATIC COVID-19; This spontaneous report received from a patient concerned a 52 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included: covid-19, and other pre-existing medical conditions included: The patient was quarantine for five days after the second time of corona. The patient had has underlying health conditions. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) dose was not reported, administered on 30-MAR-2021 14:00 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 24-DEC-2021, the patient experienced asymptomatic covid-19. Laboratory data included: COVID-19 PCR test (NR: not provided) Positive. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of asymptomatic covid-19 was not reported. This report was non-serious. This report was associated with product complaint number 90000210331


VAERS ID: 2018813 (history)  
Form: Version 2.0  
Age: 5.0  
Sex: Male  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-12-24
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, SARS-CoV-2 test
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: FLU
Current Illness:
Preexisting Conditions: None, No known allergies
Allergies:
Diagnostic Lab Data: Test Date: 20211224; Test Name; Test Result: Positive; Comments: Nasal Swab.
CDC Split Type: USPFIZER INC202101878766

Write-up: Tested positive for COVID 19.; Tested positive for COVID 19.; This is a spontaneous report received from contactable reporter(s) (Consumer or other non HCP). The reporter is the parent. A 5 year-old male patient received bnt162b2 (BNT162B2), administered in arm left, administration date 04Nov2021 (Batch/Lot number: unknown) at the age of 5 years as dose 2 (tris), single and administered in arm left (Batch/Lot number: unknown) as dose 1 (tris), single for covid-19 immunisation. The patient had no relevant medical history. Concomitant medication(s) included FLU taken for immunisation. The following information was reported DRUG INEFFECTIVE (medically significant), COVID-19 (medically significant) all with onset 24Dec2021, outcome recovering. The patient underwent the following laboratory tests and procedures sars-cov-2 test (24Dec2021) positive, Nasal Swab. Therapeutic measures were not taken as a result of drug ineffective, covid-19. The lot number for bnt162b2 was not provided and will be requested during follow up. Prior to vaccination, the patient was not diagnosed with COVID-19, Since the vaccination, the patient has been tested for COVID-19. The patient did not receive any other medications the patient received within 2 weeks of vaccination. Device Date 29Dec2021.


VAERS ID: 2019149 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-05-14
Onset:2021-12-24
   Days after vaccination:224
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO179 / 2 LA / -

Administered by: School       Purchased by: ?
Symptoms: Blood pressure abnormal, Blood pressure measurement, COVID-19, Heart rate, Heart rate abnormal, SARS-CoV-2 test, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypertension (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Cold allergy
Allergies:
Diagnostic Lab Data: Test Name: Bp; Result Unstructured Data: Test Result: shot up very bad both lower and upper; Test Name: Heart rate; Result Unstructured Data: Test Result: 83; Comments: 83bps Heart rate felt to be pounding worst than 150 while running on a treadmill; Test Date: 20211224; Test Name: Antigen; Test Result: Positive; Comments: Nasal Swab.
CDC Split Type: USPFIZER INC202200000101

Write-up: Covid test result Positive / Date 24Dec2021; Covid test result Positive / Date 24Dec2021; Heart rate suddenly going to 83; Bp shot up very bad both lower and upper; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP) from medical information team. The reporter is the patient. A 29 year-old male patient received bnt162b2 (BNT162B2), administered in arm left, administration date 14May2021 18:00 (Lot number: ewo179) at the age of 29 years as dose 2, single for covid-19 immunisation. Relevant medical history included: "catch a cold very easy type of allergy" (unspecified if ongoing). The patient''s concomitant medications were not reported. Vaccination history included: Bnt162b2 (Dose Number: 1, Batch/Lot No: ew0171, Location of injection: Arm Left), administration date: 23Apr2021, when the patient was 29 years old, for COVID-19 immunization. The following information was reported VACCINATION FAILURE (medically significant), COVID-19 (medically significant) all with onset 24Dec2021, outcome unknown; HEART RATE ABNORMAL (non-serious) with onset 2021, outcome recovered (2021); BLOOD PRESSURE ABNORMAL (non-serious) with onset 2021, outcome recovered (2021). The events heart rate suddenly going to 83 and bp shot up very bad both lower and upper were evaluated at the physician office visit. It was reported that patient did not receive other vaccine in four weeks. Heart rate suddenly going to 83 Bp shot up very bad both lower and upper (83bps Heart rate felt to be pounding worst than 150 while running on a treadmill). No covid prior vaccination. The patient underwent the following laboratory tests and procedures: blood pressure measurement (unspecified date) shot up very bad both lower and upper; heart rate (unspecified date) 83bps Heart rate felt to be pounding worst than 150 while running on a treadmill; sars-cov-2 test (24Dec2021) positive, Nasal Swab. Therapeutic measures were not taken as a result of heart rate abnormal, blood pressure abnormal. No follow-up attempts are possible. No further information is expected.


VAERS ID: 2019238 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-12-16
Onset:2021-12-24
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Migraine
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin Microgestin Fe Acyclovir
Current Illness: None
Preexisting Conditions: ADHD - No medicine is taken for this condition
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: I have had a constant headache that begin 7 days after my booster shot. I rarely got head aches before, and have never had a migraine before this. Beginning at 1am on 12/24/21, approximately 7 days after booster, I got a migraine that lasted nearly 20 hours. No over the counter medication helped. I have had a constant head ache since 12/24/2021. The pain severity varies, sometimes severe, sometimes a dull headache, but always pain at some degree. I take over the counter medication (Advil, Tylenol, Excedrin) when the pain increases, in which the over the counter medication will dull it, but does not completely get rid of it. When the headache is severe, the pain is the entire head. When the headache is dull, it always starts on the right side of my head.


VAERS ID: 2019251 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-12-15
Onset:2021-12-24
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, Blood test, Electrocardiogram, Myocardial infarction
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: typical adverse reactions, first two were moderna. 2nd dose in particular, had the typical day after with brain fog, body pain,
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: amoxycillin
Diagnostic Lab Data: 12/25/2021 ekg and whatever blood work is typically done to find evidence of a "heart event"
CDC Split Type:

Write-up: increased my anxiety reactions, actually had an anxiety attach and what felt like heart attack conditions since the booster, peaked on Christmas eve and went to emergency room, checked in, but they said there was no "heart event" after ekg and blood work. They did not ask about my date of booster. 3 weeks now from the booster and the effects are lessening but still here somewhat.


VAERS ID: 2019266 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: New York  
Vaccinated:2021-12-22
Onset:2021-12-24
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822811 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Feeling abnormal, Headache, Hyperhidrosis, Pain, Pain in extremity
SMQs:, Neuroleptic malignant syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None. Glass of Water before sleep. Two glasses of water at 9AM after awakening.
Current Illness: None.
Preexisting Conditions: None.
Allergies: None. I''m allergic to animal protein since birth, what''s showing on my arms with typical skin condition.
Diagnostic Lab Data: Not yet
CDC Split Type:

Write-up: After the vaccination I was advised by my father (doctor of medical sciences, Specialist in internal, contagious diseases and gastroenterologist to wait 30 minutes (not recommended 15) for adverse effect or allergies. 2 hours after vaccination I already felt pain in both arms and general weakness. Then I went to sleep like 9pm after having glass of water (religiously I''m practicing 1 water before sleep and 2 after awakening to avoid stroke and kick start my body) and woke up 11am next day sweated with chills. Generally feeling nothing worst than tetanus/flu shot which had similar reaction as I was thinking. I went to sleep like 9pm. Generally, December 24th I from awakening I was feeling under the weather like weak and headache like pinch here and there in my head. Then at 10am thinking about my Christmas Eve and planning the day I''ve felt like sound in my ears and later like vacuum in my ears. Then I''ve suffered something what I later google myself thunderclap pain. It lasted like few second to 30 second and My Lord never felt such a pain like for a stroke. I put ice on my head and Tylenol with 2 glasses of water. Went to sleep with fear of LIFE!


VAERS ID: 2019286 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: New York  
Vaccinated:2021-12-22
Onset:2021-12-24
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822811 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling abnormal, Formication, Thunderclap headache
SMQs:, Peripheral neuropathy (broad), Dementia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: None other than I''m allergic to animal protein since birth which shows on my arms with typical allergic skin condition
Diagnostic Lab Data: none yet
CDC Split Type:

Write-up: I have to continue here as I was in rush to submit the form as I''ve received 5 minutes to time out session message to complete the form. Thunderclap pain was going on and off for like a hour and a half. Firstly it lasted like 15-30 seconds and coming back like every few minutes. Then after I applied ice pad to my head it stopped it''s intensity to like a 5 seconds every few hours following day (during the day). I took Tylenol on 24th before sleep and like 3 following days every like 6 hours 500mg. I was really afraid and strongly considered to go to ER but unfortunately resign due to probably long waiting time and future possible problem with health insurance... Few days later like January 5th I''ve felt like something would crawl under my skull in same place I had a thunderclap pain. Generally I''m feeling weird feeling pinch on either side of top of the skull like the one you have sometimes with weather change but more intense. Also I had to put "unknown" under another vaccination field as I couldn''t proceed with the form. I didn''t receive another vaccine beside Janssen covid.


VAERS ID: 2019466 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-12-04
Onset:2021-12-24
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / 3 AR / IM

Administered by: Military       Purchased by: ?
Symptoms: Angina pectoris, Chest pain, Pulmonary pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Other ischaemic heart disease (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omeprazole 20mg - once daily, Ceterizine Hydrochloride 10mg - once daily, Losartan 25mg - once daily, Centrum Adult - once daily, Calcium 600mg - once daily
Current Illness: None
Preexisting Conditions: Hypertension, GERD
Allergies: No Known Allergies
Diagnostic Lab Data: None so far
CDC Split Type:

Write-up: Chest pain, seemingly in heart and/or lungs


VAERS ID: 2019735 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-12-22
Onset:2021-12-24
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2022-01-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058H21A / 3 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye pain, Tinnitus
SMQs:, Glaucoma (broad), Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Medical Marijuana
Current Illness: Spinal stenosis herniated disc?s in spinal
Preexisting Conditions: Spinal stenosis degenerate disc disease
Allergies: Tetracycline, cymbalta ambian
Diagnostic Lab Data: Will be contacting Doctor on Jan 10,2022
CDC Split Type:

Write-up: Ringing in my ear and slight pain in eyes


VAERS ID: 2019824 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-01
Onset:2021-12-24
   Days after vaccination:267
Submitted: 0000-00-00
Entered: 2022-01-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017B21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril, metformin
Current Illness: none
Preexisting Conditions: diabetes, hypertension
Allergies: none
Diagnostic Lab Data: positive covid test
CDC Split Type:

Write-up: covid 19 infection


VAERS ID: 2019846 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-12-13
Onset:2021-12-24
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2022-01-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032H21A / 3 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D3 and B12
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: 11 days after vaccination, severe full-body urticaria occurred


VAERS ID: 2019967 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-12-22
Onset:2021-12-24
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2022-01-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Paraesthesia, Sensory loss, Shoulder injury related to vaccine administration
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Meloxicam, Multi-Vitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: SERVA. that started around two (2) days after injection. Numbness and tingling in left arm predominately from wrist to finger tips. The numbness in no longer as acute as initially but is still there. Mostly it is just numbness in my left hand from wrist to finger tips with loss of sensitivity most noticeably in the tips the three (3) long fingers. Gripping creates a unique sensation kind of like have a carbonated beverage in my muscle tissue. There isn''t anything to do presently but to wait.


VAERS ID: 2020370 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: California  
Vaccinated:2021-12-23
Onset:2021-12-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH F00809 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lymph node pain, Lymphadenopathy
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Similar reaction occurred after administration of second dose of Pfizer COVID vaccine on 04/30/2021 and after administration of
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Substantial pain and swelling of lymph nodes underneath both arms. Pain and swelling began within 24 hours of receiving vaccine and subsided after 5 days. Took ibuprofen (1200 mg/day) to manage symptoms.


VAERS ID: 2020490 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Ohio  
Vaccinated:0000-00-00
Onset:2021-12-24
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: SARS-CoV-2 test, Suspected COVID-19, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20211228; Test Name: COVID-19 antigen test; Result Unstructured Data: Positive.
CDC Split Type: USJNJFOC20220109995

Write-up: SUSPECTED CLINICAL VACCINATION FAILURE; SUSPECTED COVID-19 INFECTION; This spontaneous report received from a patient concerned an unspecified age, white and non Hispanic or Latino male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of administration not reported, batch number: 1808978, and expiry: Unknown) dose was not reported, dose number in series was 1, 1 total, administered on 01-APR-2021 on left arm for prophylactic vaccination. No concomitant medications were reported. On 24-DEC-2021, the patient had suspected covid-19 infection. He started experiencing symptoms which included runny nose and cough since 24-DEC-2021, followed by loss of taste and smell since 26-DEC-2021. On 28-DEC-2021, the patient underwent COVID-19 antigen test which was found to be positive which result in suspected clinical vaccination failure (dose number in series was 1). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from suspected covid-19 infection, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Other Medically Important Condition). This report was associated with product quality complaint: 90000210601.; Sender''s Comments: V0: 20220109995-Covid-19 vaccine ad26.cov2.s-Suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 2020662 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: New York  
Vaccinated:2021-12-21
Onset:2021-12-24
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 067H21A / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Electrocardiogram, Hypertension, Palpitations, Rash, Rash erythematous, Rash papular, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None at the time
Current Illness: None
Preexisting Conditions: None
Allergies: NKA/NKDA
Diagnostic Lab Data: Blood tests, EKG, (12/26/21) prednisone oral (12/31/21).
CDC Split Type:

Write-up: Raised, Red, Itching patches across entire body consistent with allergy response as well as hypertension, and racing heart. These events started 7-10 days post dose and was described by a nurse as a possible delayed immune response.


VAERS ID: 2021111 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: New York  
Vaccinated:2021-10-08
Onset:2021-12-24
   Days after vaccination:77
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2889 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Headache, Increased upper airway secretion, Nasal congestion, Pain, Respiratory tract congestion, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Humira, Lorine, Easy time
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: codeine, Sofia
Diagnostic Lab Data: Covid-19 test
CDC Split Type: vsafe

Write-up: I had body aches, chills, cough, and a lot congestive in my throat and chest. I had stuff nose as well. These lasted for about 5 days and I still have a cough and headaches. On the Dec 27th I went and got tested for Covid-19, positive results.


VAERS ID: 2021286 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: California  
Vaccinated:2021-12-21
Onset:2021-12-24
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FL3197 / 1 AR / IM

Administered by: Public       Purchased by: ?
Symptoms: Anxiety, Chest discomfort, Discomfort, Dyspnoea, Tachycardia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamins and supplements
Current Illness: Unknown
Preexisting Conditions: None
Allergies: The client reported a history of her "eyes rolling back" after taking compazine.
Diagnostic Lab Data:
CDC Split Type:

Write-up: The client reported that 3 days after receiving the vaccine, they developed chest pressure, tachycardia, and mild shortness of breath. The client also reported feeling, "like I wanted to get out of my body" and stated her body felt uncomfortable. The client described these symptoms as "anxiety," but denied any history of anxiety or these symptoms prior to receiving the vaccine. The symptoms lasted 1.5 days. The client didn''t take any medications or follow up with any providers.


VAERS ID: 2021443 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-12-24
Onset:2021-12-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 331308A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Injection site bruising, Injection site reaction, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Patient received Pfizer vaccine on 12/24/21 stated she felt like administration was given to far back from the center of the arm. During vaccine administration she stated her arm felt numbness all the way down to her fingertips. She stated when she got home she noticed injection site was further back then where she is used to getting it and site was bruised. She reported to us about 2 weeks later she still has some soreness/pain in her arm and has a visible marking were injection site was given.


VAERS ID: 2021563 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-12-16
Onset:2021-12-24
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Headache, Heart rate increased, Illness, Loss of personal independence in daily activities, Mobility decreased, Nausea, Pyrexia, Thyroid function test abnormal, Thyroid pain, Thyroiditis
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypothyroidism (broad), Hyperthyroidism (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D, Vitamin C, multi vitamin on occasion
Current Illness: Thyroid nodule identified in Mid November
Preexisting Conditions: None
Allergies: Allergy to some dental glue, and silver tips (root canal), Vicoprofin
Diagnostic Lab Data: Medical test associated with Thyroiditis. Standard test for this. The endocrinologist did not know when the test were done for sure what type if Thyroiditis and it was diagnosed on Dec 28.
CDC Split Type:

Write-up: I got my Booster shot on December 16. I had nausea and headache for a day after. Then again around Christmas I started to feel extremely fatigue. I was schedule to have a fine needle biopsy of a thyroid nodule on December 28th (schedule in December before shot) and when I went to the endocrinologist i let her know my thyroid was hurting on the opposite side of the nodule. The endocrinologist did an ultra sound and said I didn?t have a nodule but had Thyroiditis. She sent me for extra bloodwork. I didn?t get an FNA biopsy. I got more sick after this visit. I had extreme fatigue, headache, nausea, elevated resting heart rate (iwatch alerted me to a resting heart rate of 150). I could barely get through 1/4 of my daily activity (laundry, cooks dinner). I had three nights of laying on the couch with low grade fever one day. I did a teledoc apt instead of emergency room to get instructions. I then made an apt that Monday on Tuesday January 4th with my primary care as she was the first doctor I could get into. My primary care prescribed a beta blocker. I saw the endocrinologist the next day. Even if I had thyroid issue it was not as pronounced until after the shot. Also the shot made me very sick for a day and 1/2 which I think may have been worse if Thyroiditis was coming on. At the time I was not diagnosed with Thyroiditis.


VAERS ID: 2022212 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-11-02
Onset:2021-12-24
   Days after vaccination:52
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19 pneumonia, Polymerase chain reaction
SMQs:, Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 11 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: cinacalcet, naloxone, suboxone, meclizine, mirtazapine, gabapentin, clopidogrel, auryxia, atorvastatin, aspirin 81 mg, albuterol, advair, tiotropium
Current Illness: angina, cystic disease of the liver, CAD, heart failure, congenital cystic kidney disease, ESRD on HD, chroinc pain and opiate use, pancytopenia, marijuana dependence, permanent afib, anxiety, depression, pulmonary HTN, anemia, polycystic kidney disease
Preexisting Conditions: angina, cystic disease of the liver, CAD, heart failure, congenital cystic kidney disease, ESRD on HD, chroinc pain and opiate use, pancytopenia, marijuana dependence, permanent afib, anxiety, depression, pulmonary HTN, anemia, polycystic kidney disease
Allergies:
Diagnostic Lab Data: Cycle Threshold: 25.8
CDC Split Type:

Write-up: COVID-19 pneumonia causing hospitalization


VAERS ID: 2024060 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-02-09
Onset:2021-12-24
   Days after vaccination:318
Submitted: 0000-00-00
Entered: 2022-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012M20A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20211224; Test Name: COVID-19 test; Test Result: Positive ; Result Unstructured Data: Positive for COVID-19 in the morning
CDC Split Type: USMODERNATX, INC.MOD20214

Write-up: Positive for COVID-19/breakthrough infection; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (Positive for COVID-19/breakthrough infection) in a 62-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 020F21A, 044A21A and 012M20A) for COVID-19 vaccination. No Medical History information was reported. On 09-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 01-Nov-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 24-Dec-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced COVID-19 (Positive for COVID-19/breakthrough infection). At the time of the report, COVID-19 (Positive for COVID-19/breakthrough infection) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 24-Dec-2021, SARS-CoV-2 test: positive (Positive) Positive for COVID-19 in the morning. No concomitant medication was reported. The treatment information was not reported. Company comment: This is a spontaneous case concerning a 62-year-old male patient with no medical history reported, who experienced non serious, unexpected events of COVID-19 (AESI). The event occurred 1 month 24 days after the third dose of mRNA-1273 vaccine. Clinical course and treatment details were not provided. The benefit-risk relationship of mRNA-1273 vaccine is not affected by this report.; Sender''s Comments: This is a spontaneous case concerning a 62-year-old male patient with no medical history reported, who experienced non serious, unexpected events of COVID-19 (AESI). The event occurred 1 month 24 days after the third dose of mRNA-1273 vaccine. Clinical course and treatment details were not provided. The benefit-risk relationship of mRNA-1273 vaccine is not affected by this report.


VAERS ID: 2024635 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-05-05
Onset:2021-12-24
   Days after vaccination:233
Submitted: 0000-00-00
Entered: 2022-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test negative, SARS-CoV-2 test positive, Urinary retention
SMQs:, Anticholinergic syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 22 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amLODIPine (NorvASC) 5 mg Tablet Directions: 1 tablet oral daily (Active) aspirin 81 mg tablet,delayed release (DR/EC) Directions: 1 tablet oral daily (Active) atorvastatin (Lipitor) 40 mg Tablet Directions: 1 tablet oral daily at be
Current Illness:
Preexisting Conditions: As Listed Common HTN, Hypothyroidism; Addt''l Med History Chronic kidney disease, stage 3 Throat/tonsillar cancer s/p chemo/radiation Prostate cancer s/p chemo/radiation Skin cancer. Significant Surg Hx As Listed Addt''l Surgical History Tonsillectomy cardiac stents. Smoking Status Never Smoker.
Allergies: NKDA
Diagnostic Lab Data: 12/24/21 ANTIGEN (-) 1/1/22, 1/6/22 PCR (-) 1/10/2022 PCR (++)
CDC Split Type:

Write-up: Admitted 12/24 with urinary retention, turned POS while in house


VAERS ID: 2025025 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-12-15
Onset:2021-12-24
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2022-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 069H21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: itching/utricaria in several places of the body.Started with the back of neck, then, the shoulders, later around the abdomen a fe days later under the breasts and back. Each day the spot would vary with knives that would calm down with Zyrtec but then again re appear the next day. medal dose pack did not work.


VAERS ID: 2025458 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-12-23
Onset:2021-12-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2022-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FL319 / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal discomfort, Blood test normal, Chest X-ray normal, Chills, Decreased appetite, Influenza virus test negative, Injection site erythema, Injection site pain, Nausea, Pain, Pyrexia, SARS-CoV-2 test negative
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: Arthritis
Allergies: No
Diagnostic Lab Data: Chest xray - Normal Bloodwork - Normal Rapid Covid and Flu - Negative
CDC Split Type: vsafe

Write-up: 24 hrs after 3rd booster . Injection site was pain and red for 2 weeks. fever, chills and body ache, upset stomach and could not eat and nausea after a month went to doctor on 7Jan2022, Given antibiotics.


VAERS ID: 2025741 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-12-24
Onset:2021-12-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041J21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Joint range of motion decreased, Pain in extremity
SMQs:, Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: none at this time
CDC Split Type:

Write-up: Patient is complaining that her arm is till sore from the 24th and that she does not have full range of motion of her arm.


VAERS ID: 2025896 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-09
Onset:2021-12-24
   Days after vaccination:259
Submitted: 0000-00-00
Entered: 2022-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19 pneumonia, Polymerase chain reaction
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: furosemide, albuterol, aripiprazole, duloxetine, Bydureon, gabapentin, mirtazapine, naltrexone, rivaroxaban, amlodipine, insulin aspart, insulin glargine, metoprolol succinate
Current Illness: T2DM, HTN, MDD, COPD, CHF, Cardiac pacemaker, polysubstance abuse
Preexisting Conditions: T2DM, HTN, MDD, COPD, CHF, Cardiac pacemaker, polysubstance abuse
Allergies: cefazolin
Diagnostic Lab Data: Cycle threshold: 39.1
CDC Split Type:

Write-up: Hospitalization due to acute respiratory failure with hypoxia 2/2 to COVID-19 PNA


VAERS ID: 2025899 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-12-07
Onset:2021-12-24
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2022-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol, atorvastatin, levetiracetam, sertraline, bactrim, vitamin d3, prednisone
Current Illness: pulmonary sarcoidosis, chronic steroid use
Preexisting Conditions: pulmonary sarcoidosis
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalization from COVID 19


VAERS ID: 2025905 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-12-24
Onset:2021-12-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3594 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Dizziness, Dyspnoea, Echocardiogram, Electrocardiogram, Feeling hot, Laboratory test normal, Palpitations
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: None
Diagnostic Lab Data: A week prior to 1-10-22 patient had an echocardiogram and EKG done at cardiologist''s office. 1-10-22, patient was seen at the hospital in the evening for an EKG.
CDC Split Type:

Write-up: Patient reported lightheadedness at the time of vaccination. I did not notice any signs of shortness of breath at the time of vaccination. Today, 1-11-22, he reported that he had an instantaneous warm sensation in his heart and a feeling of heaviness in his chest. He said that since the time he was vaccinated, he has been experiencing palpitations and shortness of breath. A week prior to 1-10-22, patient went to cardiologist. The cardiologist ran an echocardiogram and an EKG. Labs were normal. Patient was admitted to hospital last night, 1-10-22, hospitalist examined patient for myocarditis and patient''s heart is healthy and normal. Patient is convinced that he may have developed myocarditis after vaccination.


VAERS ID: 2027392 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-12-24
Onset:2021-12-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FL3198 / UNK RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Immunisation, Interchange of vaccine products, Lymphadenopathy, Vaccination site swelling
SMQs:, Medication errors (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101859246

Write-up: got some kind of under my arm swelling under my arm, where I had shot in; His under arm is swollen; I have went to get my second dose vaccine just today, the Pfizer but the first one, I took was Johnson and Johnson; booster; This is a spontaneous report received from a contactable reporter (Consumer or other non HCP). The reporter is the patient. A 49-year-old male patient received bnt162b2 (BNT162B2), intramuscular, administered in arm right, administration date 24Dec2021 (Lot number: FL3198) at the age of 49 years as dose 2 (booster), single for COVID-19 immunization. The patient''s relevant medical history was not reported. There were no concomitant medications. Vaccination history included: Johnson and Johnson vaccine (DOSE 1), administration date: 10Apr2021, when the patient was 49 years old, for COVID-19 immunization. The following information was reported: INTERCHANGE OF VACCINE PRODUCTS (non-serious) with onset 24Dec2021, outcome "unknown", described as "I have went to get my second dose vaccine just today, the Pfizer but the first one, I took was Johnson and Johnson"; IMMUNISATION (non-serious) with onset 24Dec2021, outcome "unknown", described as "booster"; VACCINATION SITE SWELLING (non-serious) with onset 25Dec2021, outcome "not recovered", described as "got some kind of under my arm swelling under my arm, where I had shot in"; LYMPHADENOPATHY (non-serious) with onset 25Dec2021, outcome "not recovered", described as "His under arm is swollen". Additional information: the consumer and reporter both were on the call (as reported). The consumer stated, "I have went to get my second dose vaccine just today, the Pfizer but the first one, I took was Johnson and Johnson and I want to make sure it''s ok to me because and I got some kind of under my arm swelling under my arm, where I had shot in." The consumer stated, "This was a second follow up vaccine, it was the booster second." The consumer stated, "The next day, the next morning I got up the next morning, I started felling swelling up under my arm." Regarding the lot number, the consumer stated, "I don''t have the number to the booster shot, that''s all at the (Pharmacy Name)." Regarding the expiration date, NDC number, and UPC number, the consumer stated, "I don''t have any of that." The reporter then stated, "Do you understand he has got the Pfizer in April or May or something, I mean he wouldn''t got the J &J in April or May or something and he is missing, it would have Pfizer are you understanding me, he wouldn''t got the J and J Friday, he woke up this morning and his arm was swell, swell, ok we got the lot number right here, the Lot number is FL3198." The reporter then stated that the first dose was Johnson and Johnson on 10Apr2021, and the second dose of vaccine was Pfizer on 24Dec2021. Regarding the anatomical site of the vaccine administration, the reporter stated, "The Johnson and Johnson at (facility name) and the Pfizer was at (pharmacy name) ''14-09'', the right arm in the muscle." Regarding other medical conditions, the reporter stated, "his under arm is swollen." Regarding other medications, the reporter stated the patient was not taking any medication. When the reporter was asked if the consumer was still experiencing the issue, the reporter stated, "Yes still swollen, got bigger." The reporter stated that the outcome of event was "persisting." As for if the consumer received treatment, the reporter stated, "no he have not done nothing so he just woke up and swollen." When asking for any further assistance, the reporter asked what they could do, regards to the doctor or emergency room; wanted to know that during this time period, what they could do.


VAERS ID: 2027399 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: South Carolina  
Vaccinated:2021-12-23
Onset:2021-12-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2022-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Interchange of vaccine products, Off label use, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101872561

Write-up: I got the J&J vaccine; I got the J&J vaccine; Vomiting; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP) for a Pfizer sponsored program (005570). The reporter is the patient. A patient (no qualifiers provided) received bnt162b2 (BNT162B2), administration date 23Dec2021 15:30 (Batch/Lot number: unknown) as dose 2 (booster), single for covid-19 immunisation. The patient''s relevant medical history and concomitant medications were not reported. Vaccination history included: J&j vaccine (Dose 1), for COVID-19 immunization. The following information was reported: OFF LABEL USE (non-serious), INTERCHANGE OF VACCINE PRODUCTS (non-serious), outcome "unknown" and all described as "I got the J&J vaccine"; VOMITING (non-serious) with onset 24Dec2021 04:00, outcome "recovered" (Dec2021), described as "Vomiting". Additional information: The patient did vaccine as a booster at 3:30 pm on 23Dec2021. At 4am, on the 24th the patient began vomiting until noon. The lot number for bnt162b2 was not provided and will be requested during follow up.


VAERS ID: 2027411 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-12-24
Onset:2021-12-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG3594 / 3 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Eye inflammation, Feeling abnormal, Immunisation, Overdose, Pruritus, Retinal vascular thrombosis
SMQs:, Anaphylactic reaction (broad), Dementia (broad), Pseudomembranous colitis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Drug abuse and dependence (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Corneal disorders (broad), Retinal disorders (narrow), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Medication errors (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101878335

Write-up: blood clot in her eye; itching; fleecing; I also had real bad diarrhea, watery; My eye looks like it is inflamed; He gave me the wrong dose, he gave me enough for 6 people.; she got the booster dose of the Pfizer Covid 19 vaccine; This is a spontaneous report received from contactable reporter(s) (Consumer or other non HCP) from medical information team. The reporter is the patient. A 67 year-old female patient received bnt162b2 (BNT162B2), administered in arm right, administration date 24Dec2021 (Lot number: FG3594) at the age of 67 years as dose 3 (booster), single for covid-19 immunisation. The patient''s relevant medical history and concomitant medications were not reported. Vaccination history included: Bnt162b2 (Dose Number: 01) first dose, administered on 13Mar2021 and 21Mar2021), for Covid-19 Immunization, reaction(s): "I didn''t had this reaction with the first two doses, just a little tired"; Bnt162b2 (Dose Number: 02), administration date: 2021, for Covid-19 Immunization, reaction(s): "I didn''t had this reaction with the first two doses but then she went home, she had a reaction to it, she went back and told him what happened to her eye and he blew me off, just a little tired but nothing happened to her eye. The following information was reported: OVERDOSE with onset 24Dec2021, outcome "unknown", described as "He gave me the wrong dose, When she turned, he already had the little bottle leaned over and the stuff out in the syringe. He said going to give you all of it'', she don''t know if you are supposed to have half of it. she don''t understand why my eye did that, in the past she had stuff administered in her system and the same thing happened to her eye, but they gave her medication for it, no longer have that medication. She don''t know what he gave to her and assuming it was the Pfizer, but when she went there he gave her J&J papers. When she got there he had already drawn out all of the bottle, all of that. He gave her too much in one syringe, the other two times they didn''t emptied the bottle. That is why now she having problem with her eye, because he gave me too much,he gave me enough for 6 people."; IMMUNISATION (non-serious) with onset 24Dec2021, outcome "unknown", described as "she got the booster dose of the Pfizer Covid 19 vaccine"; RETINAL VASCULAR THROMBOSIS (non-serious) with onset 27Dec2021, outcome "unknown", described as on her eye on the side where she received the shot "blood clot in her eye"; PRURITUS (non-serious) with onset 27Dec2021, outcome "unknown", described as "itching"; FEELING ABNORMAL (non-serious) with onset 27Dec2021, outcome "unknown", described as "fleecing"; DIARRHOEA (non-serious) with onset 27Dec2021, outcome "unknown", described as "I also had real bad diarrhea, watery"; EYE INFLAMMATION (non-serious) with onset 27Dec2021, outcome "unknown", described as "My eye looks like it is inflamed". Follow-up (29Dec2021): This is a follow-up spontaneous report from a contactable consumer patient reported for herself that: Reporter states that both of her eyes are very itchy but the right one, which is the same side as the arm she got the booster vaccine, was very blood shot. Reporter wants to know if this is a side effect of the vaccine.she got the vaccine on 24Dec2021 and that the symptoms started on Monday 27Dec2021.She got the booster dose at withheld. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 2027661 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-12-22
Onset:2021-12-24
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2022-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PH8030 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Glossodynia, Paraesthesia oral, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Chronic cough (As a child.)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202200027397

Write-up: Spicy tingling sensation at the tip of the tongue to taste; Spicy tingling sensation at the tip of the tongue to taste; Fever; Cough; This is a spontaneous report from a contactable reporter (consumer or other non-HCP). The reporter is the patient. A 39-year-old male patient received bnt162b2 (BNT162B2), administered in arm left, administration date 22Dec2021 at 17:00 (Lot number: PH8030) at the age of 39 years as dose 2, single for COVID-19 immunisation. Relevant medical history included: "Chronic cough" (unspecified if ongoing), notes: As a child. There were no concomitant medications. Vaccination history included: Bnt162b2 (DOSE 1, SINGLE; Lot number: FJ1611; Anatomical location: left arm; Administration time: 17:00; Route of administration: unspecified), administration date: 01Dec2021, when the patient was 39 years old, for COVID-19 immunisation. The following information was reported: PARAESTHESIA ORAL (non-serious), GLOSSODYNIA (non-serious) all with onset 24Dec2021 at 16:00, outcome "recovering", and all described as "Spicy tingling sensation at the tip of the tongue to taste"; PYREXIA (non-serious) with onset 24Dec2021 at 16:00, outcome "recovering", described as "Fever"; COUGH (non-serious) with onset 24Dec2021 at 16:00, outcome "recovering", described as "Cough". Therapeutic measures were taken as a result of paraesthesia oral, glossodynia, pyrexia and cough. Additional information: The patient had no allergies that he knows of. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the COVID-19 vaccine. The events did not result in doctor or other healthcare professional office/clinic visit and emergency room/department or urgent care. Treatment included lots of green tea and NyQuil for PARAESTHESIA ORAL, GLOSSODYNIA, PYREXIA and COUGH. Since the vaccination, the patient had not been tested for COVID-19.


VAERS ID: 2028172 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-12-11
Onset:2021-12-24
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2022-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030H21B / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Feeling abnormal, Hot flush, Mechanical urticaria, Oropharyngeal discomfort
SMQs:, Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Atrial Fibrillation
Allergies: None
Diagnostic Lab Data: Awaiting some testing from the allergist.
CDC Split Type:

Write-up: Demographia / continued joint paint / some weird throat bubble feeling / hot flashes through body


VAERS ID: 2028200 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-12-10
Onset:2021-12-24
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2022-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 067F21A / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Rash erythematous, Rash pruritic, SARS-CoV-2 test positive, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: NONE
CDC Split Type: vsafe

Write-up: On the 24th after I showered I had red rashes on my torso and it was really itchy and red. It got really welled up and really itchy. I contacted my doctor and he recommended a medicine which made it a little better and I kept going on with Zyrtec and finally I got days off of Zyrtec and because I stopped it started itching more and then I tested positive on Jan 3. Then I started taking Zyrtec again and the itching has gone away a little. My doctor said I need to take less Zyrtec. It comes and goes and it''s really bad.


VAERS ID: 2028287 (history)  
Form: Version 2.0  
Age: 9.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-12-22
Onset:2021-12-24
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2022-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Bell's palsy, Depression, Eating disorder, Facial paralysis, Facial paresis, Hypoaesthesia, Mastication disorder, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (narrow), Hearing impairment (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: amoxicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: My 9 year old daughter was diagnosed with bell''s palsy after she received the second vaccine shot . she received her 1st vaccine shot on November 29, 2021 and her second on December 22,2021 we noticed her left side of her face was swollen and the left side of her mouth was twisted. she lost all feeling on her left side of face, she couldn''t smile , eat properly, wink her eyes, chew her food, drink without the fluid pouring back out her mouth, drooling or laugh like a normal child. My daughter became depressed worried if she would return to normal. we as parents try to do whats best for our children thinking its safe and depending on the CDC to make sure the vaccines they developed would help us not hurt us and in this case if hurt us. The fact that we didnt hear anything from the location where she received the vaccine from nor did we hear from the CDC as the medical team told us we would. I just think this is ridiculous on how we are being treated as a human being but worst being treated this way as a child. The fact that no one has even called to apologized is ridiculous. I need answers


VAERS ID: 2028294 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-12-13
Onset:2021-12-24
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2022-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 060H21A / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspepsia, Gastritis, Oesophagitis, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Gastrointestinal nonspecific inflammation (narrow), Gastrointestinal nonspecific dysfunction (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D, Fish Oil, Digestive Enzymes, DGL Licorice Extract, Arginine, BCAA, Garlic
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 11 days after receiving the 3rd Moderna (booster) shot I began to break out in itchy full-body hives and experience persistent severe acid reflux (heartburn) and/or esophagitis/gastritis. I continue to experience all of these symptoms


VAERS ID: 2028438 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-12-22
Onset:2021-12-24
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2022-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FL3198 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NOT KNOWN
Current Illness: NONE, PATIENT HAD A covid test done, and it was negative
Preexisting Conditions: none
Allergies: NONE
Diagnostic Lab Data: PATIENT DID NOT SEEK MEDICAL CARE, HE DOES NOT HAVE A DOCTOR
CDC Split Type:

Write-up: SHORTNESS OF BREATH AND PAIN IN THE MIDDLE F IS BACK BEHIND HEART . PATIENT HAD TO HOLD IS CHEST TO BREATHE. PATIENT HAD DIFFICULTY BREATHING FOR 4 DAYS.


VAERS ID: 2028614 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-12-24
Onset:2021-12-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0809 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Mobility decreased, Neck pain, Pain, Peripheral swelling, Tremor
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine 25mcg, sotalol 80, alprazolam 1mg, atorvastatin 20mg...citalopram 20mg....OTC nothing
Current Illness: AFib, hypothyroid, mitral valve prolapse, social anxiety and depression
Preexisting Conditions:
Allergies: Penicillin, hot peppers
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Severe swelling of upper arm persisting 7 days total, immobilizing arm and neck pain with severe headache. Body shakes due to chills, full body aches.


VAERS ID: 2028675 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-12-22
Onset:2021-12-24
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2022-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ1611 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Asthmatic
Allergies: Dairy products & chocolate.
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Uncontrollable shaking throughout torso and hands for 5-15 minutes.


VAERS ID: 2028765 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-12-21
Onset:2021-12-24
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2022-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD7212 / 3 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Headache, Oral mucosal blistering
SMQs:, Severe cutaneous adverse reactions (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu Shot-soreness around the arm.
Other Medications: Lamotrigine; buspirone; pramipexole; oxcarbazepine; duloxetine
Current Illness: None
Preexisting Conditions: Epilepsy; Depression
Allergies: None
Diagnostic Lab Data: None
CDC Split Type: vsafe

Write-up: Headache; blisters in my mouth; fatigue.


VAERS ID: 2028798 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-12-24
Onset:2021-12-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032H21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Adverse event, Injected limb mobility decreased, Joint range of motion decreased, Lymphadenopathy, Pain, Product administered at inappropriate site
SMQs:, Drug abuse and dependence (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Oxycodone
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient reports adverse events from time of immunization and has still been experiencing symptoms. Patient knew booster dose was given incorrectly as it was administered as it caused pain and was too high up on her arm. She has limited range of motion and cannot fully lift up left arm since time of vaccination. She has swelling in her lymph nodes and pain that has not gone away. Since the time of vaccination, she has been taking Ibuprofen around the clock to help but it has not gotten better.


VAERS ID: 2028824 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: California  
Vaccinated:2021-12-24
Onset:2021-12-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ8757 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: no
Allergies: No Known allergies discussed
Diagnostic Lab Data: none
CDC Split Type:

Write-up: The patient should have gotten her booster 02/20/22 but instead was given the booster on 12/24/21. The patient exhibited same symptoms as expected fever and body pain for 1 to 2 days. Patient is fine and came in because she saw that she got it earlier than it was expected.


VAERS ID: 2028865 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-12-21
Onset:2021-12-24
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2022-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ8762 / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Acoustic stimulation tests, Ear, nose and throat examination, Magnetic resonance imaging, Neurological examination, Tinnitus
SMQs:, Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: OTC Lysine 500 mg x 2 daily, OTC selinium 200 mcg x 1 daily, OTC B supplement, 1x daily
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Hearing test, MRI, Neurology exam, ENT exam.
CDC Split Type:

Write-up: Three days after booster, very severe tinnitus, L$gR.


VAERS ID: 2029568 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-12-13
Onset:2021-12-24
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2022-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Rash, Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Women?s multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Intermittent red and itchy rash on neck, cheek, hands and wrists. Would flare up and subside irregularly. This has lasted on and off for multiple weeks, from 12/24/21 through 1/12/22. Symptoms subside when taking Zyrtec allergy medication but continue to come back irregularly.


VAERS ID: 2030952 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-08-01
Onset:2021-12-24
   Days after vaccination:145
Submitted: 0000-00-00
Entered: 2022-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20220118304

Write-up: CONTRACTED COVID; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) dose was not reported, administered on AUG-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 24-DEC-2021, the patient experienced contracted covid. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of contracted covid was not reported. This report was non-serious. This report was associated with a product quality complaint: 90000211192.


VAERS ID: 2031107 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: New York  
Vaccinated:2021-11-19
Onset:2021-12-24
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2022-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 2 - / OT

Administered by: Military       Purchased by: ?
Symptoms: Blood test, CD4/CD8 ratio, Haemoglobin, Platelet count, SARS-CoV-2 antibody test, SARS-CoV-2 test, Surgery, Swollen tongue, Tongue discolouration
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Boil; Impetigo contagious
Preexisting Conditions: Medical History/Concurrent Conditions: Foot surgery; Heart valve disorders
Allergies:
Diagnostic Lab Data: Test Date: 20210724; Test Name: SARS-CoV-2 IgG antibody test; Result Unstructured Data: 36 low; Test Date: 20210827; Test Name: Blood test; Result Unstructured Data: Not reported; Test Date: 20210827; Test Name: CD4/CD8 ratio; Result Unstructured Data: 2.05; Test Date: 20210827; Test Name: Hemoglobin; Result Unstructured Data: 16.5; Test Date: 20210827; Test Name: Platelet count; Result Unstructured Data: 31; Test Name: SARS-CoV-2 test; Result Unstructured Data: Negative
CDC Split Type: USJNJFOC20220114730

Write-up: SWOLLEN TONGUE; WHITE TONGUE; SURGERY; This spontaneous report received from a patient concerned a 61-year-old adult male and unknown ethnicity. The patient''s weight was 158 pounds, and height was 72 inches. The patient''s past medical history included: foot surgery (both feet), and concurrent conditions included: heart valve defect, Impetigo contagious, and boils (impetigo, and boils both contagious and keeps on repeating). The patient works in banking. The patient previously received covid-19 vaccine ad26.cov2.s (dose number in series 1) (suspension for injection, route of admin, and batch number: 1805022, expiry: unknown) dose was not reported, 1 total, administered at left arm on 09-FEB-2021 for prophylactic vaccination. Patient stated again that he was calling due to the fact that he was sick previous to the vaccine but the vaccine seemed to help him get better. He stated that he tolerated the vaccine well and that since then he was about six months in. Patient stated that he was not recovering but rather his condition was worsening. He had seen 4 doctors recently and 3 whom he saw a year ago. He was terrific prior to the vaccine. The vaccine was great but then he was not so great and seem to be going back to the past where he was prevaccination. He states his antibody level had never been above 28. The patient reported a low antibody level of 36-38 (consumer''s partner had an antibody count of 140, and his friends had counted over 400). The patient was tested on 24-JUL-2021, received results on 07-AUG-2021. The patient experienced weight loss after receiving the vaccine. His weight dropped from 165 pounds to 142 pounds. The patient stated that the vaccine increased his metabolism. He eats ice-cream daily at bedtime for weight gain (dose number in series 1). The patient had blood test on 27-AUG-2021 and the date on the report was 28-AUG-2021, with results ABS TD19 plus lymph (result 382 reference range: 12-645), ABS CD3 (result 1230 reference range 622-2402), ABS (absolute) CD4 plus helper (result 826 reference range 254-1519), percent CD19 plus lymphs (result 19.1 percent reference range 3.3 to 25.4 percent), percent CD3 plus lymphs (result 61.5 percent reference range 57.5 to 87.2 percent), percent CD4 plus lymphs (result 41.3 percent reference range 30.8 to 58.5 percent), CD4 / CD8 ratio (result 2.05 reference range 0.92 to 3.72), hemoglobulin (result 16.5 reference range 13.0 to 17.7), platelets (result 31 reference range 150 to 450). Laboratory data (dates unspecified) included: SARS-CoV-2 test (NR: not provided) negative. (All events with dose number series 1) The outcome of the increased metabolism, low antibody count, low platelet counts and weight loss was not reported. The patient received booster covid-19 vaccine ad26.cov2.s (dose number in series 2) (suspension for injection, route of admin, and batch number: unknown, expiry: unknown) dose was not reported, 1 total, administered on 19-NOV-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 24-DEC-2021, the patient had unspecified surgery. As a result, patient''s tongue was often swollen, and that turned white. The patient stated that he thought it was allergy. The patient''s doctor thought it was allergic reaction to anesthesia (all events with dose number series 2). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the surgery, swollen tongue and white tongue was not reported. This report was serious (Other Medically Important Condition). This case, involving the same patient is linked to 20210829077.; Sender''s Comments: V0:20220114730-COVID-19 VACCINE AD26.COV2.S-Surgery. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 2032082 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-10-25
Onset:2021-12-24
   Days after vaccination:60
Submitted: 0000-00-00
Entered: 2022-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8027 / 3 LA / IM
FLUR4: INFLUENZA (SEASONAL) (FLUBLOK QUADRIVALENT) / PROTEIN SCIENCES CORPORATION - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Cough, Headache, Pyrexia, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Pfizer Dose 2 2021
Other Medications: Vitamins
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Covid (12/24/21)
CDC Split Type: vsafe

Write-up: 12/24/2021 Covid symptoms started with runny nose, mild headache, a bit of a fever but very mild, very bad cough, and congestion. Symptoms lasted 6-7 days. Tested positive on 12/24/21 with a home test and then went to a pharmacy to get tested through PCR which was positive.


VAERS ID: 2032113 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-12-23
Onset:2021-12-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2022-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Melatonin, TRAZODONE
Current Illness: No
Preexisting Conditions: Tourette disorder Allergic rhinitis due to allergen Acquired buried penis Vitamin D deficiency DMDD (disruptive mood dysregulation disorder) (HCC) Anxiety disorder OCD (obsessive compulsive disorder) ADHD (attention deficit hyperactivity disorder) Low HDL (under 40)
Allergies: Tenex [Guanfacine], Adhesive Tape
Diagnostic Lab Data: no
CDC Split Type:

Write-up: He has been having nausea since the day after he received his first Covid 12/23/2021. He still has nausea but started getting better on 1/10. No other symptoms noted. Mom states that he is eating and drinking okay and his nausea is usually worse in the morning before eating. nurse spoke with PCP and nausea care in child.


VAERS ID: 2032151 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-12-23
Onset:2021-12-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2022-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3594 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Bystolic, Rosuvastatin, "Relief Factor"
Current Illness: None
Preexisting Conditions: hypertension
Allergies: None
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Low grade fever, chills, malaise started the afternoon following my booster. Treated with ibuprofen, fluids, rest. Mostly resolved by the second morning after the injection,.


VAERS ID: 2032228 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-12-24
Onset:2021-12-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Interchange of vaccine products, Product administered to patient of inappropriate age, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: The patient came to the pharmacy for a booster vaccine. He had received Pfizer for his first 2 doses. Moderna was administered as a booster when patient is under 18 years old. Patient reported having a mild fever for about 1 day as a side effect from his vaccine but no other side effects.


VAERS ID: 2033269 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-11-23
Onset:2021-12-24
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2022-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Back pain, Blood pressure increased, Chest X-ray, Chest pain, Condition aggravated, Electrocardiogram, Full blood count, Hyperthyroidism, Joint swelling, Laboratory test, Lymph node pain, Lymphadenopathy, Neck pain, Pain, Pain in jaw, Thyroid function test abnormal, Vaginal haemorrhage
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Cardiomyopathy (broad), Hypothyroidism (broad), Hyperthyroidism (narrow), Osteonecrosis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Lump at injection site for several months following the tetanus vaccine.
Other Medications: Synthroid; Lo Loestrin; Krill oil; multi-vitamin
Current Illness: None
Preexisting Conditions: Graves? disease
Allergies: None
Diagnostic Lab Data: EKG (12/26/21) CBC and other lab work (12/26/21 and 1-11-22) Chest X-ray (12/26/21) Chest CT scan (1/14/22) Transvaginal ultrasound (1/14/22) Stress test (scheduled for 1/17/22) Further tests anticipated following CT scan, ultrasound and stress test
CDC Split Type:

Write-up: Baseball size swollen and painful lymph node around left arm pit approximately 24 hours following 3rd booster, lasting about 5 days. Chest pain, swollen ankles and abdominal/stomach pain 31 days following 3rd booster. Chest pain radiating to back, abdominal/stomach pain and stroke level blood pressure (210/109) 32 days following 3rd booster (I never had high blood pressure before this and therefore never took or was prescribed blood pressure medicine). Chest pain radiating to back, left jaw pain, left neck pain, abdominal/stomach pain, stroke level blood pressure (210/109) 33 days following 3rd booster. Was admitted to the ER on 33 as a result of BP and these other symptoms. Started BP medication at ER and thereafter. Unexplained vaginal bleeding beginning 1/11/22 and continuing through the date of this report. I?m addition, thyroid levels that had been stable on a consistent dose of Synthroid for almost 10 years went haywire following the 1st dose of the vaccine and remain unstable.


VAERS ID: 2035887 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-12-14
Onset:2021-12-24
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2022-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3594 / 3 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Cardiac function test, Delirium, Imaging procedure, Laboratory test normal
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: fluoxetine, armour, valium, lamotrigine, simvastatin
Current Illness: none
Preexisting Conditions: depression/anxiety hypothyroid dementia chronic back pain
Allergies: abilify
Diagnostic Lab Data: lab work cardiac workup neurological workup with imaging of head
CDC Split Type:

Write-up: one week post vaccine pt developed acute delirum was unable to recognized family members, was not oriented to placed time, self was hospitalized for event and all testing negative for stroke, heart attack, no abnormal lab values


VAERS ID: 2036157 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-20
Onset:2021-12-24
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2022-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 018F21A / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal distension, Hysteroscopy, Intermenstrual bleeding, Muscle spasms, Ultrasound pelvis
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: already reported (Vaers ID 1457888 / Report 581570)
Other Medications: Amlodipine, Fish Oil, Folic Acid, Century 21 Senior MultiVitamin, Fexofenadine, Vitamin D3, Probiotics, BioSil, Glucosamine Chondroitin
Current Illness: None
Preexisting Conditions: Blood Pressure
Allergies: None
Diagnostic Lab Data: Since I already had a pelvic ultrasound 5/10/2021 and hysteroscopy on 7/6/2021 after the Dose 2 breakthrough bleed where a small polyp was removed and found negative. My OB/GYN agreed that a 2nd hysteroscopy was not needed so we decided to conduct a pelvic ultrasound on 1/9/2022. The results were fine and no additional work is needed but monitoring if I get another cycle this month.
CDC Split Type:

Write-up: I am post menopause and have not had a menstruation cycle for a few years. Similar to Dose 2 prior, after receiving my booster shot, I had breakthrough bleeding about 1 month after the shot. My period lasted 3 days this time. I had significant cramps and bloating a week prior and for several weeks past my period.


VAERS ID: 2037445 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: California  
Vaccinated:2021-12-16
Onset:2021-12-24
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2022-01-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 069H21A / 3 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Pruritus, Urticaria, Urticaria chronic
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lamotrigine
Current Illness:
Preexisting Conditions:
Allergies: Bactrim
Diagnostic Lab Data:
CDC Split Type:

Write-up: 8 days after booster experienced severe hives and itching in patches all over body that would come and go. Back of the head and neck, groin, back, arms, and hips were all particularly bad. Overall worse in the evening and if something rough was rubbing/touching that area. Chronic urticaria and pruritus ever since. Mild most of the time with some bad flare-ups every few days.


VAERS ID: 2037510 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Texas  
Vaccinated:2021-12-24
Onset:2021-12-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 213D21A / 2 - / OT

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, SARS-CoV-2 test, SARS-CoV-2 test positive
SMQs:, Extravasation events (injections, infusions and implants) (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: The patient had no known allergies.
Allergies:
Diagnostic Lab Data: Test Date: 2021; Test Name: COVID-19 virus test; Result Unstructured Data: Negative; Test Date: 2021; Test Name: COVID-19 virus test; Result Unstructured Data: Negative; Test Date: 2021; Test Name: COVID-19 virus test; Result Unstructured Data: Negative; Test Date: 2021; Test Name: COVID-19 virus test; Result Unstructured Data: Negative; Test Date: 2021; Test Name: COVID-19 virus test; Result Unstructured Data: Negative; Test Date: 2021; Test Name: COVID-19 virus test; Result Unstructured Data: Negative; Test Date: 20220103; Test Name: SARS-CoV-2 rapid diagnostic test; Result Unstructured Data: Positive
CDC Split Type: USJNJFOC20220104451

Write-up: COVID-19 TEST POSITIVE; SORENESS AROUND SHOT; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included: The patient had no known allergies. The patient received covid-19 vaccine ad26.cov2.s (dose number in series 1) (suspension for injection, route of admin not reported, batch number: 201A21A , and expiry: UNKNOWN) dose was not reported,1 total, administered on 18-JUN-2021 for prophylactic vaccination. On an unspecified date in late AUG-2021 and early SEP-2021, the patient had 5 or 6 Covid-19 test, all result showed negative. No adverse events reported post vaccination (dose number in series 1). The patient received covid-19 vaccine ad26.cov2.s (dose number in series 2) (suspension for injection, route of admin not reported, batch number: 213D21A, and expiry: UNKNOWN) dose was not reported,1 total, administered on 24-DEC-2021 on left arm for prophylactic vaccination. No concomitant medications were reported. On 24-DEC-2021, the patient experienced soreness around shot. On 03-JAN-2022, the patient was tested positive for Covid-19 through rapid nasal swab, hence covid-19 test positive (dose number in series 2). The patient was enquiring that is it possible to get a positive/false positive result receiving the vaccine. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from soreness around shot on 26-DEC-2021, and the outcome of covid-19 test positive was not reported. This report was non-serious.


VAERS ID: 2037818 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: California  
Vaccinated:2021-12-01
Onset:2021-12-24
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2022-01-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FL3197 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Chest pain, Electrocardiogram normal, X-ray normal
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Ekg text, xray test, and blood work. All 1/14/21 Doctors concluded they found nothing abnormal. Still has chest pain .
CDC Split Type:

Write-up: Continues Chest Pain , sharpness . Have gone to ER and made appts with Dr. They say it''s notmal for teen boys to have chest pain. It''s not normal


VAERS ID: 2037834 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-12-23
Onset:2021-12-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2022-01-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Axillary pain, Injection site pain, Swelling, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Gummy multivitamin, fiber gummies
Current Illness: None
Preexisting Conditions: Right elbow pain from past injury
Allergies: Insect venom allergy
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Sore arm at injection site then progressed into left armpit and left armpit became swollen and tender.


VAERS ID: 2037919 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-12-23
Onset:2021-12-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2022-01-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ1611 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Consciousness fluctuating, Depression, Dyspnoea, Fatigue, Illness, Inflammation, Migraine, Mobility decreased, Nausea, Pain in extremity, Peripheral swelling, Sleep disorder, Vomiting
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Depression (excl suicide and self injury) (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin, imitrex, low-dose naltrexone, D3 supplement, Super B complex supplement, CoQ-10 supplement
Current Illness: None
Preexisting Conditions: Dysautonomia, PTSD
Allergies: Sulfa, amoxicillin, penicillin, oral allergy syndrome (allergic to most fruits and nuts), soy allergy, hay fever, cat allergy
Diagnostic Lab Data: None
CDC Split Type:

Write-up: The night after I was vaccinated, I awoke multiple times desperately gasping for air. I do not have apnea or anything like that; it was from the booster shot. I was feeling progressively worse and worse and by about 6 AM on the 24th of December, I began vomiting more violently than is typical for me when sick. I was drifting in and out of consciousness throughout the morning, only to be awaken by the same gasping for air, except now the gasping was accompanied by a severe need to vomit. By the evening the vomiting had subsided but I was still extremely nauseous, occasionally out of breath for no reason, and feeling very exhausted. I did not get out of bed for two days except to vomit, refill my water, and use the facilities. For two weeks days after the booster shot I was overcome with moderately severe depression. My body was inflamed for three weeks, with my rings difficult to remove from my fingers. I had a migraine for a week straight after receiving the booster. It is by far the most sick I have ever been after receiving any type of vaccination. Oddly enough, the booster left my arm feeling sore for much less time than the first two shots did. But everything else aside from my arm was much, much worse with the booster. If I had not already been on vacation, I would have missed at least four days of work due to how sick I was from the booster. The only lingering symptoms I have as of Jan 15, 2020 are very mild global inflammation and depression (more than I normally have) For this reason, I answered "unknown" for question #20 The side effects I experienced were alarming enough that I would have gone to the ER under normal circumstances, but I did not go because the hospitals are overwhelmed with covid patients right now. I did mention the symptoms to the physician''s assistant last time I was seen though.


VAERS ID: 2037963 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-07-09
Onset:2021-12-24
   Days after vaccination:168
Submitted: 0000-00-00
Entered: 2022-01-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tested Positive for Covid


VAERS ID: 2037981 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-09-17
Onset:2021-12-24
   Days after vaccination:98
Submitted: 0000-00-00
Entered: 2022-01-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tested Positive for Covid


VAERS ID: 2038013 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-19
Onset:2021-12-24
   Days after vaccination:280
Submitted: 0000-00-00
Entered: 2022-01-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006B21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tested Positive for Covid


VAERS ID: 2038376 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-12-24
Onset:2021-12-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 331308A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chest discomfort, Cough, Dizziness, Eye disorder, Fatigue, Headache, Illness, Influenza like illness, Nausea, Pyrexia, Reaction to previous exposure to any vaccine, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Corneal disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: MMR , and Flu vaccine at 16-18 months Old
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: 12/24 Same day he got really sick. Couldn''t get out of bed for 5-6 days with flu like symptoms, fatigue, headache and weakness. No fever. Started to move around more after the 8th day but still a lot of nausea, headache, fatigue, chest congestion, dizziness. At week 3 he is falling asleep throughout the day even while talking. Vomiting in the mornings, difficulty waking up, low energy. Two covid rapid test have been Negative. PCR test on 01/10/2022 Negative. He has not been able to go back to school as of 01/16/2022 because of debilitating symptoms. He coughs at night and sleeps a lot. A lot of indigestion and vomiting in the mornings more frequently than before. He had a fever 01/15/2021 morning that quickly disappeared. He has chest congestion and eye sensitivity. He says ?like a migraine without the pain? and i noticed his eyes were out of alignment. Im attaching a photo showing Strabismus.


VAERS ID: 2039363 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: California  
Vaccinated:2021-12-24
Onset:2021-12-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FL8095 / 1 LA / IM
FLU4: INFLUENZA (SEASONAL) (AFLURIA QUADRIVALENT) / SEQIRUS, INC. P100369747 / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Underdose
SMQs:, Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ATORVASTATIN, LEFLUNOMIDE, TAMSULOSIN, FERROUS SULFATE, NITROFURANTOIN, FLUCONAZOLE
Current Illness:
Preexisting Conditions:
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT RECEIVED PEDIATRIC DOSE OF VACCINE WHEN THEY WERE ALREADY 12 YEARS OLD. THERE IS EVIDENCE THAT THIS IS OKAY AS LONG AS PATIENT RECEIVES THE ADULT DOSAGE ON THE ON THEIR SECOND SHOT. WAS CAUGHT WHEN PATIENT CAME IN FOR SECOND SHOT AND PATIENT WILL BE INFORMED


VAERS ID: 2042130 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-12-16
Onset:2021-12-24
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2022-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027H21B / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None yet
CDC Split Type:

Write-up: Since December 24- I keep getting extremely itchy skin and hives. The reaction goes away after taking Zyrtec or Allegra but comes back next day. I hope this reaction goes away soon!


VAERS ID: 2042553 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: California  
Vaccinated:2021-12-21
Onset:2021-12-24
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2022-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045J21A / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Mechanical urticaria, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Apri (Birth Control) and Hydroxyzine 10 mg
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Dermatographia, hives. Starts in hands and scalp, spreads to entire rest of body. No closing of throat or shortness of breath, only intense itching and can draw on skin.


VAERS ID: 2042846 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-09
Onset:2021-12-24
   Days after vaccination:259
Submitted: 0000-00-00
Entered: 2022-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Amnesia, Aortic valve calcification, Atelectasis, COVID-19, Computerised tomogram abnormal, Confusional state, Cough, Hiatus hernia, Infection, Inflammation, Lung opacity, SARS-CoV-2 test positive, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodiPINe (NORVASC) 10 MG PO Tab TAKE ONE TABLET EVERY DAY FOR BLOOD PRESSURE Med Note (Mon Oct 11, 2021 12:04 PM) FILLED 10/04/21 X 30 DAYS aspirin 81 MG PO Chew Tab take 81 mg by mouth once daily. fluticasone (FLONASE) 50 MCG/
Current Illness: CVA (cerebrovascular accident) ? Hypertension
Preexisting Conditions: CVA (cerebrovascular accident) ? Hypertension
Allergies: No Known Drug Allergy
Diagnostic Lab Data: 74y.o. year old male presented to hospital due to syncopal episode. Patient was found to be COVID + 12/24. He is currently not requiring any supplemental O2. + cough. It is noted patient uses albuterol inhaler at home, BMI 34, also history of hypertension. I have counseled the patient regarding monoclonal antibody and reviewed EUA. He is agreeable with proceeding with treatment. Patient s/p Pfizer vaccine 3-4 2021 Patient recently prescribed PCN by dentist due to teeth extraction. CT: IMPRESSION: 1. Limited exam. No large central pulmonary embolism. 2. Bibasilar and right upper lobe groundglass and linear attenuation likely related to atelectasis and/or infectious or inflammatory process. 3. Calcifications of the aortic valve. 4. Small hiatal hernia.
CDC Split Type:

Write-up: This is a 74y.o. male admitted from home after he had a syncopal episode after going to the bathroom patient is somewhat confused is not sure if he had a bowel movement forehead P he states as he was leaving the bathroom and collapsed on the floor patient does remember that otherwise he has amnesia the exact event previous history of CVA and hypertension family history of diabetes patient is married he does not drink he may smoke patient is unsure of his history he apparently was positive for Covid but was not aware of being exposed to anybody nor having any specific Covid symptoms. Patient has no known allergies. He takes medication for his blood pressure.


VAERS ID: 2042858 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-06-02
Onset:2021-12-24
   Days after vaccination:205
Submitted: 0000-00-00
Entered: 2022-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006C21A / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury, Back pain, COVID-19, Chest X-ray abnormal, Chronic kidney disease, Condition aggravated, Dyspnoea, Emotional distress, Hypercapnia, Hyporesponsive to stimuli, Lethargy, Mental status changes, Pneumonia, Positive airway pressure therapy, Sacral pain
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (broad), Chronic kidney disease (narrow), Arthritis (broad), Tumour lysis syndrome (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol (PROVENTIL, VENTOLIN, PROAIR) HFA 108 (90 Base) MCG/ACT INHAL Aero Soln inhale 1-2 Puffs into the lungs as needed for FOR SHORTNESS OF BREATH. (disp insurance-pref prod) Unknown Unknown time Med Note (Fri Dec 10, 2021 11:11
Current Illness: Anemia ? Arthropathy, unspecified, site unspecified ? Atypical chest pain 12/20/2015 ? CAD (coronary artery disease) DES x 1 SVG-RCA 5/8/18; chronic occluded RCA, moderate stenosis in LCx per cath 1/2004 ? Cardiac arrhythmia ? Chronic back pain ? Chronic kidney disease (CKD) RECEIVED DIALYSIS 3 X''S ONLY IN LIFE, after CABG ? Chronic obstructive asthma, unspecified ? Chronic pain ? Clostridium difficile colitis ? Congestive heart failure diastolic ? COPD (chronic obstructive pulmonary disease) ? Coronary artery disease ? Coronary artery disease involving coronary bypass graft of native heart with angina pectoris chronic occluded RCA, moderate stenosis in LCx per cath 1/2004, S?P CABG in 11/14/2009 LIMA -LAD, SVG-OM, SVG, PDA, HAD STERNAL WOUND INFECTION ? COVID-19 ? CVA (cerebral vascular accident) 06/23/2017 left pontine; "2 Major" ? Diabetes mellitus, type II ? DM (diabetes mellitus) ? DVT (deep venous thrombosis) right lower extremity, likely provoked ? Dyslipidemia ? GERD (gastroesophageal reflux disease) ? Heart attack ? Hypertension ? Morbid obesity with BMI of 45.0-49.9, adult ? Neuropathy ? On fluid restricted diet ? Osteoarthritis ? Palpitations ? PTSD (post-traumatic stress disorder) ? RLS (restless legs syndrome) ? Sciatica ? Sleep apnea ? TIA (transient ischemic attack) 2 ? Valvular heart disease ? Yeast infection
Preexisting Conditions: Anemia ? Arthropathy, unspecified, site unspecified ? Atypical chest pain 12/20/2015 ? CAD (coronary artery disease) DES x 1 SVG-RCA 5/8/18; chronic occluded RCA, moderate stenosis in LCx per cath 1/2004 ? Cardiac arrhythmia ? Chronic back pain ? Chronic kidney disease (CKD) RECEIVED DIALYSIS 3 X''S ONLY IN LIFE, after CABG ? Chronic obstructive asthma, unspecified ? Chronic pain ? Clostridium difficile colitis ? Congestive heart failure diastolic ? COPD (chronic obstructive pulmonary disease) ? Coronary artery disease ? Coronary artery disease involving coronary bypass graft of native heart with angina pectoris chronic occluded RCA, moderate stenosis in LCx per cath 1/2004, S?P CABG in 11/14/2009 LIMA -LAD, SVG-OM, SVG, PDA, HAD STERNAL WOUND INFECTION ? COVID-19 ? CVA (cerebral vascular accident) 06/23/2017 left pontine; "2 Major" ? Diabetes mellitus, type II ? DM (diabetes mellitus) ? DVT (deep venous thrombosis) right lower extremity, likely provoked ? Dyslipidemia ? GERD (gastroesophageal reflux disease) ? Heart attack ? Hypertension ? Morbid obesity with BMI of 45.0-49.9, adult ? Neuropathy ? On fluid restricted diet ? Osteoarthritis ? Palpitations ? PTSD (post-traumatic stress disorder) ? RLS (restless legs syndrome) ? Sciatica ? Sleep apnea ? TIA (transient ischemic attack) 2 ? Valvular heart disease ? Yeast infection
Allergies: Albuterol Nausea and/or vomiting This is a sensitivity not an allergy per patient Pt has had duo-neb (albuterol/ipratropium) without issue ? Iodinated Diagnostic Agents Heart rhythm/rate changes and Nausea and/or vomiting ? Codeine Other Patient states she has a "sensitivity" to, however can take 1/2 hydrocodone tablet
Diagnostic Lab Data: Patient was seen and examined on 12/24/2021. The electronic chart / pertinent notes reviewed. Patient is a 66y.o. with a past medical history of COPD on 3.5L nc at baseline, HTN, DM2, CAD s/p CABG, CHF with preserved EF, pulmonary hypertension, CKD IV, OSA, and anemia who who presented to facility with a complaint of shortness of breath. Patient currently on bipap and still lethargic so is poor historian, much of the history is obtained from the chart. She was found to be satting 36% by EMS at home. Placed on NRB which was then weaned to 6L nasal cannula. Patient still lethargic and she is a difficult ABG stick, so she was placed empirically on bipap for presumed CO2 retention. Upon my evaluation, patient on bipap with fio2 32%. She is slow to answer but spontaneously alert with eyes open following commands. Per bedside RN, this is an improvement in her mentation from prior. Patient states she is comfortable with bipap and is feeling better. Emotionally distressed at learning she has COVID. Complaining of pain in her back and sacrum. She was vaccinated x2 with moderna. She had a CXR which is being read as multifocal pneumonia. Of note, patient recently discharged on 12/15 from our facility for AKI on CKD. She was COVID negative during that admission.
CDC Split Type:

Write-up: Patient was seen and examined on 12/24/2021. The electronic chart / pertinent notes reviewed. Patient is a 66y.o. with a past medical history of COPD on 3.5L nc at baseline, HTN, DM2, CAD s/p CABG, CHF with preserved EF, pulmonary hypertension, CKD IV, OSA, and anemia who who presented to facility with a complaint of shortness of breath. Patient currently on bipap and still lethargic so is poor historian, much of the history is obtained from the chart. She was found to be satting 36% by EMS at home. Placed on NRB which was then weaned to 6L nasal cannula. Patient still lethargic and she is a difficult ABG stick, so she was placed empirically on bipap for presumed CO2 retention. Upon my evaluation, patient on bipap with fio2 32%. She is slow to answer but spontaneously alert with eyes open following commands. Per bedside RN, this is an improvement in her mentation from prior. Patient states she is comfortable with bipap and is feeling better. Emotionally distressed at learning she has COVID. Complaining of pain in her back and sacrum. She was vaccinated x2 with moderna. She had a CXR which is being read as multifocal pneumonia. Of note, patient recently discharged on 12/15 from our facility for AKI on CKD. She was COVID negative during that admission.


VAERS ID: 2042923 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-15
Onset:2021-12-24
   Days after vaccination:100
Submitted: 0000-00-00
Entered: 2022-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Blood magnesium normal, COVID-19, Chest X-ray normal, Chills, Cough, Electrocardiogram normal, Full blood count normal, Metabolic function test, Pain, Pleuritic pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: START taking these medications Details budesonide (PULMICORT) 90 MCG/ACT INHAL inhaler inhale 1 Puff into the lungs twice daily for 30 days., Disp-1 Each, R-0, Normal CONTINUE these medications which have CHANGED Details vitamin D (
Current Illness: Anxiety ? Asthma ? Controlled diabetes mellitus type II without complication ? Depression ? Essential hypertension ? Family history of premature CAD ? High cholesterol ? Hyperlipidemia ? Irregular menstrual cycle ? Left knee pain s/p fall in early 2020 ? Low back pain ? Vitamin D deficiency
Preexisting Conditions: Anxiety ? Asthma ? Controlled diabetes mellitus type II without complication ? Depression ? Essential hypertension ? Family history of premature CAD ? High cholesterol ? Hyperlipidemia ? Irregular menstrual cycle ? Left knee pain s/p fall in early 2020 ? Low back pain ? Vitamin D deficiency
Allergies: Latex Rash/Itching ? Cephalosporins
Diagnostic Lab Data: The patient is a 32 year old female with pmhx of HTN, HLD, DM-II who presents to the ED with fever, chills, dry cough, and body aches that started on 12/22/21. She came in today due to pleuritic chest pain, stating she has pain with deep inspiration. Her vitals on arrival are BP 143/90, temp 99.8, HR 96, SpO2 97%. Heart and lung exam is normal. The patient is alert and oriented, not in any acute distress. ECG is NSR. COVID test is positive. Tops neg. coags normal. CBC and CMP stable. Mag slightly low at 1.6. CXR shows NAP. The patient was given Ibuprofen with improvement in symptoms. The patient''s well''s criteria is 0. The patient was given supportive care instructions and recommend she do a follow up phone call with her PCP. She was given strict return precautions. She was given RX for pulmicort and Vit D. She was given pulse ox at discharge and order for MAB. The patient is stable for discharge home. She understands and agrees to the plan.
CDC Split Type:

Write-up: The patient is a 32 year old female with pmhx of HTN, HLD, DM-II who presents to the ED with fever, chills, dry cough, and body aches that started on 12/22/21. She came in today due to pleuritic chest pain, stating she has pain with deep inspiration. Her vitals on arrival are BP 143/90, temp 99.8, HR 96, SpO2 97%. Heart and lung exam is normal. The patient is alert and oriented, not in any acute distress. ECG is NSR. COVID test is positive. Tops neg. coags normal. CBC and CMP stable. Mag slightly low at 1.6. CXR shows NAP. The patient was given Ibuprofen with improvement in symptoms. The patient''s well''s criteria is 0. The patient was given supportive care instructions and recommend she do a follow up phone call with her PCP. She was given strict return precautions. She was given RX for pulmicort and Vit D. She was given pulse ox at discharge and order for MAB. The patient is stable for discharge home. She understands and agrees to the plan.


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